• Title/Summary/Keyword: prophylactic

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Micronutrients and prevention of cervical pre-cancer in HPV vaccinated women: a cross-sectional study

  • Chandrika J Piyathilake;Suguna Badiga;Nongnut Thao;Pauline E Jolly
    • Korean Journal of Community Nutrition
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    • v.28 no.1
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    • pp.61-73
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    • 2023
  • Objectives: Prophylactic vaccines against high-risk human papillomaviruses (HR-HPVs) hold promise to prevent the development of higher grade cervical intraepithelial neoplasia (CIN 2+) and cervical cancer (CC) that develop due to HR-HPV genotypes that are included in HPV vaccines, but women will continue to develop CIN 2+ and CC due to HR-HPV genotypes that are not included in the quadrivalent HPV vaccine (qHPV) and 9-valent HPV vaccine (9VHPV). Thus, the current vaccines are likely to decrease but not entirely prevent the development of CIN 2+ or CC. The purpose of the study was to determine the prevalence and determinants of CIN 2+ that develop due to HR-HPVs not included in vaccines. Methods: Study population consisted of 1476 women tested for 37 HPVs and known to be negative for qHPVs (6/11/16/18, group A, n = 811) or 9VHPVs (6/11/16/18/31/33/45/52/58, group B, n = 331), but positive for other HR-HPVs. Regression models were used to determine the association between plasma concentrations of micronutrients, socio-demographic, lifestyle factors and risk of CIN 2+ due to HR-HPVs that are not included in vaccines. Results: The prevalence of infections with HPV 31, 33, 35 and 58 that contributed to CIN 2+ differed by race. In group A, African American (AA) women and current smokers were more likely to have CIN 2 (OR = 1.76, P = 0.032 and 1.79, P = 0.016, respectively) while in both groups of A and B, those with higher vitamin B12 were less likely to have similar lesions (OR = 0.62, P = 0.036 and 0.45, P = 0.035, respectively). Conclusions: We identified vitamin B12 status and smoking as independent modifiable factors and ethnicity as a factor that needs attention to reduce the risk of developing CIN 2+ in the post vaccination era. Continuation of tailored screening programs combined with non-vaccine-based approaches are needed to manage the residual risk of developing HPV-related CIN 2+ and CC in vaccinated women.

Evaluation of schistosomula lung antigen preparation and soluble egg antigen vaccines on experimental schistosomiasis mansoni

  • Nagwa S. M. Aly;Hye-Sook Kim;Maysa A. Eraky;Asmaa A. El Kholy;Basma T. Ali;Shin-ichi Miyoshi;Rabab E. Omar
    • Parasites, Hosts and Diseases
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    • v.61 no.3
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    • pp.251-262
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    • 2023
  • Schistosomiasis causes significant morbidity and mortality worldwide. This study aimed to assess the effect of schistosomula lung antigen preparation (SLAP) and soluble egg antigen (SEA) on a murine schistosomiasis mansoni model. Ninety laboratory-bred male Swiss albino mice were divided into 6 groups. Two doses of the vaccine were given at 2-week intervals. All mice were subcutaneously infected with 80±10 Schistosoma mansoni cercariae 2 weeks after the last vaccination dose. They were sacrificed 7 weeks post-infection. Parasitological and histopathological studies were conducted to assess the effect of inoculated antigens (single or combined). The results showed that the combination of SLAP and SEA (combination group) led to a significant reduction in worm burden (65.56%), and liver and intestine egg count (59% and 60.59%, respectively). The oogram pattern revealed a reduction in immature and mature eggs (15±0.4 and 10±0.8, respectively) and an increased number of dead eggs in the combination group (P<0.001). In terms of histopathological changes, the combination group showed notably small compact fibrocellular egg granuloma and moderate fibrosis in the liver. A high percentage of destroyed ova was observed in the intestine of the combination group. This study demonstrates for the first time the prophylactic effect of combined SLAP and SEA vaccine. The vaccine induced a significant reduction in the parasitological and pathological impacts of schistosomiasis mansoni in hepatic and intestinal tissues, making it a promising vaccine candidate for controlling schistosomiasis.

Re-expansion Pulmonary Edema in a patient with Secondary Spontaneous Pneumothorax Following Closed Thoracostomy: A Case Report (이차성 자연기흉 환자에게 폐쇄식 흉관삽입술로 인한 재팽창성 폐부종에 관한 증례보고)

  • Seon Woo Oh;Su Wan Kim
    • Journal of Medicine and Life Science
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    • v.18 no.3
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    • pp.61-65
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    • 2021
  • Although re-expansion pulmonary edema (RPE) is rare (incidence rate <1%), it is associated with a mortality rate of >20%; therefore, early diagnosis and treatment are important. We report a case of RPE following chest tube insertion in a patient with spontaneous pneumothorax. We have specifically focused on the mechanism underlying RPE and the possible etiology. An 82-year-old man with a history of chronic anemia, chronic obstructive pulmonary disease, diabetes mellitus, and hypertension was referred to the emergency department for management of recurrent right-sided pneumothorax. We performed emergency closed thoracostomy for suspected tension pneumothorax, which led to stabilization of the patient's vital signs; however, he coughed up frothy pink sputum accompanied by severe right-sided chest pain 30 min postoperatively. The patient showed new-onset right pulmonary consolidation on chest radiography, as well as desaturation, tachycardia, and tachypnea and was diagnosed with RPE. He was transferred to the intensive care unit for mechanical ventilation and supportive treatment using diuretics, ionotropic agents, and prophylactic antibiotics. RPE gradually resolved, and the patient was extubated 3 days after admission. He has not experienced recurrent pneumothorax or pulmonary disease for 4 months. We emphasize the importance of RPE prevention and that aggressive ventilator care and supportive treatment can effectively treat RPE following an accurate understanding of the underlying pathogenetic mechanisms and risk factors.

Seroma prevention with topical Abnobaviscum sclerotherapy following excision of giant cervical lipoma

  • Jun Ho Choi;Seung Yeon Choi;Jae Ha Hwang;Kwang Seog Kim;Sam Yong Lee
    • Archives of Craniofacial Surgery
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    • v.24 no.1
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    • pp.10-17
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    • 2023
  • Background: Lipomas are common benign tumors of mesenchymal origin that are composed of mature adipocytes. Giant lipomas have a diameter ≥ 10 cm in one or more dimensions or weigh at least 1,000 g. The surgical excision of a giant lipoma requires extensive dissection, increasing the risk of a seroma, which can cause surgical site complications such as wound infection and necrosis. Sclerotherapy with Abnobaviscum (Viscum album extract) is a relatively new technique used to reduce malignant pleural effusion. In this study, we evaluated the effectiveness of prophylactic sclerotherapy using Abnobaviscum to decrease seroma after giant lipoma excision. Methods: We conducted a retrospective medical record review of patients who underwent surgical excision for giant lipoma of the neck from January 2019 to December 2022. Sclerotherapy was performed on the first postoperative day in patients who consented to the procedure, and Abnobaviscum was instilled through the existing Hemovac drain. We compared the clinical course between those who underwent postoperative sclerotherapy and those who did not. Results: Among the 30 patients who underwent giant lipoma excision, we applied sclerotherapy with Abnobaviscum to 15 patients. The average time from surgery to Hemovac removal was statistically shorter in patients who underwent sclerotherapy (p= 0.004). Furthermore, seroma formation was significantly reduced in patients receiving sclerotherapy (p= 0.003). Conclusion: In patients undergoing giant lipoma excision, sclerotherapy using Abnobaviscum helps reduce postoperative seroma formation during the initial postoperative period. It can be an excellent method to reduce complications related to seroma and attenuate patients' postoperative burden.

Anti-thrombotic effects of ginsenoside Rk3 by regulating cAMP and PI3K/MAPK pathway on human platelets

  • Hyuk-Woo Kwon ;Jung-Hae Shin ;Man Hee Rhee ;Chang-Eun Park ;Dong-Ha Lee
    • Journal of Ginseng Research
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    • v.47 no.6
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    • pp.706-713
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    • 2023
  • Background and objective: The ability to inhibit aggregation has been demonstrated with synthetically derived ginsenoside compounds G-Rp (1, 3, and 4) and ginsenosides naturally found in Panax ginseng 20(S)-Rg3, Rg6, F4, and Ro. Among these compounds, Rk3 (G-Rk3) from Panax ginseng needs to be further explored in order to reveal the mechanisms of action during inhibition. Methodology: Our study focused to investigate the action of G-Rk3 on agonist-stimulated human platelet aggregation, inhibition of platelet signaling molecules such as fibrinogen binding with integrin αIIbβ3 using flow cytometry, intracellular calcium mobilization, dense granule secretion, and thromboxane B2 secretion. In addition, we checked the regulation of phosphorylation on PI3K/MAPK pathway, and thrombin-induced clot retraction was also observed in platelets rich plasma. Key Results: G-Rk3 significantly increased amounts of cyclic adenosine monophosphate (cAMP) and led to significant phosphorylation of cAMP-dependent kinase substrates vasodilator-stimulated phosphoprotein (VASP) and inositol 1,4,5-trisphosphate receptor (IP3R). In the presence of G-Rk3, dense tubular system Ca2+ was inhibited, and platelet activity was lowered by inactivating the integrin αIIb/β3 and reducing the binding of fibrinogen. Furthermore, the effect of G-Rk3 extended to the inhibition of MAPK and PI3K/Akt phosphorylation resulting in the reduced secretion of intracellular granules and reduced production of TXA2. Lastly, G-Rk3 inhibited platelet aggregation and thrombus formation via fibrin clot. Conclusions and implications: These results suggest that when dealing with cardiovascular diseases brought upon by faulty aggregation among platelets or through the formation of a thrombus, the G-Rk3 compound can play a role as an effective prophylactic or therapeutic agent.

Anti-Allergic Effects of Angelica gigas Nakai and Corni fructus extract (AC) on degranulation and production of cytokine in RBL-2H3 mast Cells (RBL-2H3 세포에서 당귀(當歸) 및 산수유(山茱萸) 복합추출물의 알레르기 개선에 대한 효과)

  • Tae Woo Oh
    • Herbal Formula Science
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    • v.31 no.4
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    • pp.315-325
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    • 2023
  • Objectives : Recently, research has been actively conducted on the efficacy of complexes based on oriental medicine prescriptions for improving immune activity and allergies. In this study, In this study, we aimed to examine the effect of Angelica gigas Nakai and Corni fructus extract (AC), medicinal herbs, among candidate drugs derived through preliminary experiments with various components of oriental medicine prescriptions for allergies, on allergies in RBL-2H3 cells. Methods : We evaluated the effect of the ethanol extract of Ulmus on the allergic inflammatory response in anti-DNP-IgE activated DNP-HSA in RBL-2H3 cells. Cell toxicity was determined by WST-1 assay and the markers of degranulation such as beta-hexosaminidase, histamine, TNF-α and IL-6 production of inflammatory mediators and FcεRI-mediated expression. Results : The results showed that treatment with AC extract (20, 40 and 80㎍/㎖) noncytotoxic levels and significantly inhibited the release of β-hexosaminidase, histamine and the production of TNF-α and IL-6 in RBL-2H3 by the antigen stimulation. Conclusions : These results indicate that AC extract exhibits anti-allergic activity through inhibition of degranulation and inhibition of inflammatory mediators and cytokine release. These findings suggest that AC extract may have potential as a prophylactic and therapeutic agent for the treatment of various allergic diseases.

Transarterial Embolization for Sporadic Renal Angiomyolipoma: Patient Selection and Technical Considerations for Optimal Therapeutic Outcomes (산발성 신장 혈관근지방종에 대한 경동맥 색전술: 최적의 치료 결과를 위한 환자 선택 및 기술적 고려 사항)

  • Yena Jung;Min Jeong Choi;Bong Man Kim;You Me Kim;Yumi Seo
    • Journal of the Korean Society of Radiology
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    • v.83 no.3
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    • pp.559-581
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    • 2022
  • Although renal angiomyolipoma (AML) is a benign tumor, treatment may be necessary occasionally because it can cause potentially life-threatening retroperitoneal hemorrhage. Transarterial embolization (TAE) is a safe and effective treatment option to prevent the hemorrhagic rupture of AMLs and relieve the symptoms caused by enlarged lesions or active bleeding. However, there is no clear consensus regarding the indications for prophylactic TAE in patients with sporadic renal AMLs. In urgent TAE for bleeding AMLs, there is a likelihood of incomplete embolization when the focus is on stabilizing the clinical symptoms. This pictorial essay discusses the patient selection and technical considerations to achieve optimal therapeutic effects as well as the follow-up findings after TAE.

Use of Magnetic Resonance Imaging for Evaluating Residual Breast Tissue After Robotic-Assisted Nipple-Sparing Mastectomy in Women With Early Breast Cancer

  • Wen-Pei Wu;Hung-Wen Lai;Chiung-Ying Liao;Joseph Lin;Hsin-I Huang;Shou-Tung Chen;Chen-Te Chou;Dar-Ren Chen
    • Korean Journal of Radiology
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    • v.24 no.7
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    • pp.640-646
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    • 2023
  • Objective: Prospective studies on postoperative residual breast tissue (RBT) after robotic-assisted nipple-sparing mastectomy (R-NSM) for breast cancer are limited. RBT presents an unknown risk of local recurrence or the development of new cancer after curative or risk-reducing mastectomies. This study investigated the technical feasibility of using magnetic resonance imaging (MRI) to evaluate RBT after R-NSM in women with breast cancer. Materials and Methods: In this prospective pilot study, 105 patients, who underwent R-NSM for breast cancer at Changhua Christian Hospital between March 2017 and May 2022, were subjected to postoperative breast MRI to evaluate the presence and location of RBT. The postoperative MRI scans of 43 patients (age, 47.8 ± 8.5 years), with existing preoperative MRI scans, were evaluated for the presence and location of RBT. In total, 54 R-NSM procedures were performed. In parallel, we reviewed the literature on RBT after nipple-sparing mastectomy, considering its prevalence. Results: RBT was detected in 7 (13.0%) of the 54 mastectomies (6 of the 48 therapeutic mastectomies and 1 of the 6 prophylactic mastectomies). The most common location for RBT was behind the nipple-areolar complex (5 of 7 [71.4%]). Another RBT was found in the upper inner quadrant (2 of 7 [28.6%]). Among the six patients who underwent RBT after therapeutic mastectomies, one patient developed a local recurrence of the skin flap. The other five patients with RBT after therapeutic mastectomies remained disease-free. Conclusion: R-NSM, a surgical innovation, does not seem to increase the prevalence of RBT, and breast MRI showed feasibility as a noninvasive imaging tool for evaluating the presence and location of RBT.

Trend Analysis of Pediatric Dentistry Patients at Seoul National University Dental Hospital: a Study on the Impact of the COVID-19 Outbreak

  • Hee-Sun Choi;Hyuntae Kim;Ji-Soo Song;Teo Jeon Shin;Hong-Keun Hyun;Jung-Wook Kim;Ki-Taeg Jang;Young-Jae Kim
    • Journal of the korean academy of Pediatric Dentistry
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    • v.50 no.4
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    • pp.452-468
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    • 2023
  • This study aims to investigate changes in dental service use among pediatric patients during the COVID-19 pandemic. The analysis was performed by collecting information about the number of visits, age, gender, diagnoses, and treatments for patients at the Pediatric Dentistry Department of Seoul National University Dental Hospital from January 2017 to December 2022. Compared with the period from 2017 to 2019, the total number of visits decreased during the COVID-19 pandemic, with a substantial decline in 2020. Patients in all age groups, except those aged 10 - 14, experienced decreased visits, and there was no significant gender difference. Z29.8 (need for other specified prophylactic measures) declined in all age groups, especially among those aged 0 - 4, except for those 20 years and older. K02.1 (caries of dentine) was sought by the age groups in the following order: 10 - 14, 15 - 19, 5 - 9, and 0 - 4 years, with the most significant decrease in the 0 - 4 years age group compared to others. K07.4 (malocclusion, unspecified) decreased in younger groups aged 9 and below but increased in older groups aged 10 and above. During the period from 2020 to 2022, preventive, restorative, pulp, and trauma treatments decreased, but surgical and orthodontic treatments increased compared with the previous three years. The use of sedation decreased and general anesthesia increased during COVID-19 compared to pre-pandemic. This study describes the impact of the COVID-19 pandemic on pediatric dentistry, making it a valuable reference for future pandemics.

Ginsenoside Rk3 suppresses U46619-induced human platelets aggregation through regulation of cAMP and PI3K/Akt pathway (U46619 유도의 사람 혈소판에서 cAMP 및 P I3K/Akt 경로의 조절을 통한 Ginsenoside Rk3의 응집억제 효과)

  • Dong-Ha Lee
    • Journal of Applied Biological Chemistry
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    • v.66
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    • pp.221-226
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    • 2023
  • Proper activation and aggregation of platelets are necessary, but excessive or abnormal aggregation can lead to cardiovascular diseases such as stroke, thrombosis, and atherosclerosis. Therefore, identifying a substance that can regulate or inhibit platelet aggregation is important for preventing and treating these diseases. Several studies have shown that certain ginsenoside compounds in Panax ginseng can inhibit platelet aggregation. Among these compounds, Rk3 (G-Rk3) from Panax ginseng needs to be further explored in order to reveal the mechanisms of action during inhibition. G-Rk3 significantly increased amounts of cyclic adenosine monophosphate (cAMP) and led to significant phosphorylation of cAMP-dependent kinase substrates vasodilator-stimulated phosphoprotein and inositol 1,4,5-trisphosphate receptor. Furthermore, the effect of G-Rk3 extended to the inhibition of PI3K/Akt phosphorylation resulting in the reduced secretion of intracellular granules. Ultimately, G-Rk3 effectively inhibited platelet aggregation. Therefore, we suggest G-Rk3's potential as a prophylactic or therapeutic agent for cardiovascular diseases caused by faulty platelet aggregation.

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